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Abstract: Background: Low seat belt use and higher crash rates contribute to persistence of motor vehicle crashes as the leading cause of teenage death. Service-learning has been identified as an important component of public health interventions to improve health behavior. Methodology: A service-learning intervention was conducted in eleven selected high schools across the United States in the 2011–2012 school year. Direct morning and afternoon observations of seat belt use were used to obtain baseline observations during the fall semester and post-intervention observations in the spring. The Mann–Whitney U test for 2 independent samples was used to evaluate if the intervention was associated with a statistically significant change in seat belt use. We identified factors associated with seat belt use post-intervention using multivariable logistic regression. Results: Overall seat belt use rate increased by 12.8%, from 70.4% at baseline to 83.2% post-intervention (p <0.0001). A statistically significant increase in seat belt use was noted among white, black, and Hispanic teen drivers. However, black and Hispanic drivers were still less likely to use seat belts while driving compared to white drivers. Female drivers and drivers who had passengers in their vehicle had increased odds of seat belt use. Conclusion: A high school service-learning intervention was associated with improved seat belt use regardless of race, ethnicity, or gender, but did not eliminate disparities adversely affecting minority youth. Continuous incorporation of service-learning in high school curricula could benefit quality improvement evaluations aimed at disparities elimination and might improve the safety behavior of emerging youth cohorts. [Copyright &y& Elsevier]

The article focuses on the health of adolescents around the world using an international comparable data. It describes various indicators related to adolescent health which were selected for their importance in public health and their coverage of health outcomes in the young people. It mentions that the worst adolescent health profiles belonged to the sub-Saharan Africa, where there is a persisting high mortality due to infectious and maternal causes.

There have been dramatic changes in adolescent health status over the past decade that have resulted from successful interventions. Overall mortality rates are down 14%, and many morbidities have declined. Today we know many of the elements that reduce risk: parental caring and connectedness, parental expectations for school and parent availability all outweigh family structure, ethnicity, and income. Likewise, schools can be extremely protective when young people feel connectedness. Factors associated with successful interventions include: strengthening families; strengthening educational involvement; expanding economic opportunities; and supporting youth development, not just problem reduction. Priorities for the next decade include: establishing resiliency-building interventions; developing positive correlates of negative behaviors; establishing broader multisectorial interdisciplinary teams; and formulating a new, more inclusive framework for adolescent health and development. [ABSTRACT FROM AUTHOR]